Fetal outcome of cases with diaphragmatic hernia

Objective: The aim of this study is to report the short-term morbidity of congenital diaphragmatic hernia at a tertiary referral center in Karachi, Pakistan.
Methods: It is a retrospective cohort study of fetuses with congenital diaphragmatic hernia from January 2001 to December 2011. This includes all cases with prenatal diagnosis and those presenting in the postnatal period. This study analyses the survival of these cases and assesses the prognostic factors associated with the mortality of this condition.
Results: During the 11 year study period, 65 cases of diaphragmatic hernia were identified. Among these, 41 cases were diagnosed in the antenatal period while the rest of the 24 presented in the postnatal period. Fifty-eight out of the 65 (89%) were born alive. Only 38% of these survived beyond 28 days of life. Factors like antenatal diagnosis and birthweight
significantly influenced the outcome while mode of delivery, site of lesion and gestational age at delivery did not affect the prognosis.
Conclusion: The overall mortality of congenital diaphragmatic hernia remains high. Survival rate of isolated hernia was substantially higher than those who had associated anomalies. The data from this study will provide the basis for counseling women in our setup.